Improved prognosis of cirrhosis patients with esophageal varices and thrombocytopenia treated by endoscopic variceal ligation plus partial splenic embolization

• Published in: Digestive diseases and sciences 2006-02, Vol.51 (2), p.352-358
• Main Authors: OHMOTO, Kenji, YOSHIOKA, Naoko, TOMIYAMA, Yasuyuki, SHIBATA, Norikuni, TAKESUE, Michihiko, YOSHIDA, Koji, KUBOKI, Makoto, YAMAMOTO, Shinichiro
• Format: Article
• Language: English
• Subjects: Aged; Biological and medical sciences; Embolization, Therapeutic; Endoscopy; Esophageal and Gastric Varices - complications; Esophageal and Gastric Varices - surgery; Feeding. Feeding behavior; Female; Follow-Up Studies; Fundamental and applied biological sciences. Psychology; Gastroenterology. Liver. Pancreas. Abdomen; Hematologic and hematopoietic diseases; Humans; Hypersplenism - complications; Hypersplenism - therapy; Ligation; Liver Cirrhosis - complications; Liver. Biliary tract. Portal circulation. Exocrine pancreas; Male; Medical sciences; Middle Aged; Other diseases. Semiology; Platelet diseases and coagulopathies; Prospective Studies; Thrombocytopenia - complications; Treatment Outcome; Vertebrates: anatomy and physiology, studies on body, several organs or systems
• ISSN: 0163-2116; 1573-2568
• DOI: 10.1007/s10620-006-3137-8

The aim of this study was to assess the efficacy of the combination of endoscopic variceal ligation (EVL) and partial splenic embolization (PSE) compared with EVL alone in cirrhosis patients with thrombocytopenia. In a prospective study, 84 cirrhosis patients with esophageal varices and thrombocytopenia (platelet count < 50,000/mm(3)) underwent EVL plus PSE (N = 42) or EVL alone (N = 42). Primary end points assessed during the follow-up period included the recurrence of varices, progression to variceal bleeding, and death. Comparison between combined treatment and variceal ligation alone by multivariate analysis showed a hazard ratio of 0.44 for the recurrence of varices (P = 0.02), 0.19 for progression to variceal bleeding (P = 0.01), and 0.31 for death (P = 0.04). These results suggest that the combination of EVL plus PSE can prevent the recurrence of varices, progression to variceal bleeding, and death in cirrhosis patients with esophageal varices and thrombocytopenia.